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Open Access Case report

Severe and isolated headache associated with hypertension as unique clinical presentation of posterior reversible encephalopathy syndrome

Gregorio Paolo Milani1*, Alberto Edefonti2, Giacomo Tardini1, Elisa Arturi1, Claudia Maria Cinnante3, Emanuela Anna Laicini1, Ernesto Leva4, Alberto Maria Cappellari5, Carlo Agostoni6 and Emilio Filippo Fossali1

Author Affiliations

1 Foundation IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Pediatric Emergency Department, Milan, Italy

2 Foundation IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Pediatric Nephrology and Dialysis Department, Milan, Italy

3 Foundation IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Neuroradiology Department, Milan, Italy

4 Foundation IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Pediatric Surgery Department, Milan, Italy

5 Foundation IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy

6 Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ospedale Maggiore Policlinico, Pediatric Clinic 2, Milan, Italy

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BMC Pediatrics 2014, 14:190  doi:10.1186/1471-2431-14-190

Published: 25 July 2014

Abstract

Background

Posterior reversible encephalopathy syndrome is a potentially reversible clinicoradiologic syndrome characterized by headache, mental confusion, visual disturbances and seizures associated with posterior cerebral lesions on radiological imaging. Prompt treatment of this condition is mandatory to avoid severe irreversible complications.

Case presentation

We report a 9-year-old boy with arterial hypertension and headache as unique clinical presentation of posterior reversible encephalopathy syndrome.

Conclusions

Severe and isolated headache associated with arterial hypertension can be the unique clinical presentation of posterior reversible encephalopathy syndrome. This syndrome must be considered even in absence of all typical symptoms to prevent the progression of a potentially life threatening condition.

Keywords:
Posterior reversible encephalopathy syndrome; Arterial hypertension; Headache